Regulating "Choice": Sterilization Abuse in the United States, Then and Now

by Jaime Anno, MPH Candidate, Mailman School of Public Health, Columbia University

Sterilization, including forced termination of fertility, and other forms of birth control have historically been implemented in the name of "scientific" eugenics -- the practice of improving the quality of a population by restricting or aborting the child bearing capacity of some groups of individuals. Often the state has endorsed these practices, determining that the reproductive capacity of certain individuals cannot be exercised in the interest of society; that is, sometimes society has decided that certain children should not be born.

Throughout the first half of the twentieth century in the United States, various authorities targeted individuals in interracial relationships for sterilization. Other targeted groups included persons suffering from epilepsy and "feeblemindedness." Individuals who medical and other authorities labeled sexually promiscuous or homosexual were also vulnerable, as were institutionalized people, especially people of color. Medical staff in asylums of various kinds, and in jails and welfare wards engaged in this practice, sometimes under the direction of judicial or psychiatric authority.

Angela Davis points out that aggressive sterilization abuse was often contemporaneous with and provoked by fears that "the white race" was undergoing dangerous degradation, a phenomenon that commentators called "race suicide." Many white authorities and others identified the antidote to "race suicide" - sterilization of people of color. Davis explains that "although the operations were justified as measures to prevent the reproduction of 'mentally deficient persons,'" the men and women sterilized were disproportionately black. Davis notes that between 1964 and 1981, "approximately 65 percent of the women sterilized in North Carolina were Black and approximately 35 percent were white". <!--[if !supportFootnotes]-->[1]<!--[endif]-->

By the middle of the twentieth century, state eugenics boards were much more likely to designate people of color than whites as "mentally unfit" to reproduce, even when these persons had never been hospitalized. These designations clearly reflected the race and class of the targets. Typically, a young woman was visited by a social worker because her family received welfare. Social workers' notes indicated concern about "promiscuity," and recorded warnings that the family would be thrown off the welfare rolls if the offending girl were not sterilized. Outside authorities conflated issues of control over sexuality and bodies with issues of gender, race, and class.

Today, eugenics boards and commissions have been disbanded across the country, and most Americans consider eugenics outdated and unjust. However, even today, forms of sterilization abuse occurs. Adele Clarke observes, "Subtle sterilization abuses include situations in which a woman or man legally consents to sterilization, but the social conditions in which they do so are abusive - the conditions of their lives constrain their capacity to exercise genuine reproductive choice and autonomy."<!--[if !supportFootnotes]-->[2]<!--[endif]-->

Other forms of subtle sterilization abuse can occur when women lack the abortion option; when people may become pregnant while economic constraints govern their reproductive choices; when people considering sterilization do not understand that the effects of the operation are permanent; and when people possess inadequate information about contraceptive alternatives to sterilization.

Thus, while scientific eugenics no longer occurs under that name, the determination and the practice of controlling the reproduction of some groups and supporting the reproduction of other groups persists in the United States.